Certified Medical Coding Specialist Medical Coding (CMCS) Sample 3 — Questions and Answers
Question 1: Which section of CPT contains codes for pathology and laboratory services?
- 70000-79999
- 80000-89999 (Correct answer)
- 90000-99999
- 00100-01999
Correct answer: 80000-89999
CPT codes in the 80000-89999 range are designated for pathology and laboratory services.
Question 2: Under the outpatient coding guidelines, which condition is sequenced as the principal diagnosis?
- The condition that caused the patient's death
- The chronic condition always takes priority
- The condition chiefly responsible for the visit after study (Correct answer)
- The first condition listed by the physician
Correct answer: The condition chiefly responsible for the visit after study
For outpatient settings, the condition established after study to be chiefly responsible for the visit is sequenced as the first-listed diagnosis.
Question 3: Modifier -25 is used to indicate:
- A reduced service was performed
- A significant, separately identifiable E/M service on the same day as a procedure (Correct answer)
- The procedure was discontinued
- A repeat procedure by the same physician
Correct answer: A significant, separately identifiable E/M service on the same day as a procedure
Modifier -25 is appended to an E/M code when a significant, separately identifiable E/M service is performed the same day as a procedure.
Question 4: Which ICD-10-CM guideline applies when coding signs and symptoms that are associated routinely with a confirmed diagnosis?
- Code the sign/symptom as an additional code
- Do not code signs/symptoms that are integral to the confirmed diagnosis (Correct answer)
- Always code signs/symptoms first
- Signs and symptoms are never coded with a confirmed diagnosis
Correct answer: Do not code signs/symptoms that are integral to the confirmed diagnosis
Signs and symptoms that are integral to and routinely associated with a disease process should not be assigned as additional codes.
Question 5: What does the abbreviation NEC stand for in ICD-10-CM?
- Not Elsewhere Classified (Correct answer)
- Not Entirely Confirmed
- Non-Essential Condition
- Not Evaluated Clinically
Correct answer: Not Elsewhere Classified
NEC stands for 'Not Elsewhere Classified,' indicating the coder has a specific condition but no specific code exists for it.
Question 6: A patient undergoes an open reduction and internal fixation (ORIF) of a right femoral shaft fracture. Which body system CPT section is used?
- Integumentary
- Musculoskeletal (Correct answer)
- Cardiovascular
- Nervous System
Correct answer: Musculoskeletal
ORIF procedures on bones and fractures are found in the Musculoskeletal System section of CPT (20000-29999).
Question 7: Which federal law primarily governs the privacy and security of individually identifiable health information?
- EMTALA
- HIPAA (Correct answer)
- HITECH Act alone
- Affordable Care Act
Correct answer: HIPAA
HIPAA (Health Insurance Portability and Accountability Act) is the primary federal law governing PHI privacy and security.
Certified Medical Coding Specialist Medical Coding (CMCS) Sample 3
Which section of CPT contains codes for pathology and laboratory services?